Quantitative comparison between amyloid deposition detected by (99m)Tc-Diphosphonate imaging and myocardial deformation evaluated by strain echocardiography in transthyretin-related cardiac amyloidosis.

Aurora Affiliations

Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke’s Medical Centers


BACKGROUND: Management of cardiac amyloidosis (CA) is related to amyloid deposition. Our aim was to assess the effect of amyloid deposition on myocardial function.Methods and Results:Twenty-eight patients with transthyretin mutation and a group of 14 controls underwent echocardiography to quantify left ventricular (LV) dimensions, function, and global (G) longitudinal (L), radial (R) and circumferential (C) strain (S). (99m)Tc-3,3-diphosphono-1,2-propanodicarboxylic-acid-scintigraphy ((99m)Tc-DPD) was used to quantify CA. (99m)Tc-DPD revealed accumulation in 14/28 patients (CA group) and no accumulation (no-CA group) in 14. Cardiac accumulation was lower-than-bone uptake in 5 (mild-CA group) and higher-than-bone uptake in 9 (severe-CA group). Ejection fraction was similar among groups. GLS was lower (P

CONCLUSIONS: Myocardial deformation is impaired in a different stage of CA. The (99m)Tc-DPD HRI correlated well with morphologic, diastolic and strain abnormalities.

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